Can Stress Mimic Allergic Reactions?

Dr. Anna Feldweg

Can stress, if great enough, cause you to have allergic reactions? I was going through a very stressful period in my life and kept breaking out in hives. I had allergy tests done, and the doctor said I was allergic to environmental things and some foods (beef, pork). The doctor prescribed Zyrtec. I took the Zyrtec for a year, and the hives occurred only a couple times. My life stress got much better, and I weaned myself off the Zyrtec and haven't had any hives since I quit taking it. I have avoided beef but have eaten pork. I'm wondering if I truly had food allergies now. Can people have periods where they just have a compromised immune system and need short-term help?

Related

The connection between stress and chronic hives is well recognized, although I don't think of stress as mimicking an allergic reaction. Rather, your last sentence better represents how allergists think about the link between these two conditions. The cause of chronic hives (defined as a condition in which the person has hives on most days of the week, for six weeks or longer) in most cases does not appear to be an external allergy to anything. Instead, chronic hives are believed to arise from some problem with the control of allergy cells (mast cells and basophils), such that they become overly active, or fire randomly. A hive forms when allergy cells within the skin become activated and release histamine and other natural chemicals, causing the overlying skin to swell, become red, and itch intensely. As the chemicals dissipate, the hive clears and disappears until the process starts again.

Once the problem of chronic hives has started, stress definitely makes it harder to control. However, stress isn't thought to be the sole cause of hives, nor can controlling stress eliminate hives once they appear. There are many examples of the body not functioning smoothly during periods of stress. Twitches in nerves, headaches, diarrhea, poor sleep, and depression are just a few of the many, many disorders that tend to begin during times of stress. They are probably all related to some loss of normal regulation over body processes.

In some people with chronic hives, antibodies (proteins intended to help the body fight infection) capable of sticking to the surface of allergy cells can be detected, though the exact role of these antibodies hasn't been proven conclusively. In other people, it may be that their basophils (another type of allergy cell) become too easily activated. Unfortunately, these explanations are still being researched and are not yet of use to patients.

Chronic hives often resolve spontaneously (just as they appeared) after a couple of years while some people can have the problem for a decade or more. Still, I do not think of hives as a condition that compromises the immune system, as people with hives have no trouble fighting off infections. If anything, I would characterize hives as a reflection of an overactive immune system, or one that isn't operating as smoothly as it should.

Some allergists evaluate chronic hives by performing skin testing and then advising the person to avoid anything that comes up positive. Other allergists specifically do not perform skin tests, because they firmly believe the problem is not the result of an external allergy and don't want to have the person avoid things unnecessarily. Often, people with hives can't be skin tested because their skin will react as a result of being pricked during testing, and the "positive" results are meaningless. However, until the causes of this condition are more clearly understood, no one approach is absolutely correct in evaluating the problem.

To return to the question you asked about food allergy: I would go back to the allergist and discuss your diet. Skin testing for food is not very reliable for some foods, and it is very possible to have a positive result and still be able to eat that food without any adverse reaction, as you discovered. The allergist may want to retest you, or if you've mistakenly eaten beef once or twice without a problem, he or she may opt to have you eat small and increasing amounts under observation, to test whether you really have an allergy. The question is definitely worth revisiting. I would not bother repeating your allergy tests to environmental things (pollens, dust mites, etc). Those tests are highly accurate and do not change much over the course of a couple of years. Also, allergens you breathe in are unlikely to cause or significantly impact chronic hives.

This site complies with the HONcode standard for trustworthy health information: verify here.

Advertising Notice

This Site and third parties who place advertisements on this Site may collect and use information about
your visits to this Site and other websites in order to provide advertisements about goods and services of
interest to you. If you would like to obtain more information about these advertising practices and to make
choices about online behavioral advertising, please click here.